THE NEW SCREENING AND DIAGNOSTIC CRITERIA OF GESTATIONAL DIABETES: WHAT IMPACT?

Abstract

Introdudion: In 2010, the International Association of Diabetes and Pregnancy Study Groups consensus panel proposed new diagnostic criteria for gestational diabetes mellitus. In light of this consensus, by 2011 Portugal updated its recommendations for diagnosis of gestational diabetes, abandoning the Carpenter and Coustan diagnostic criteria. The aim of this study was centered on assessing the impact of implementing this new diagnostic criteria. Methods: In this study, an evaluation of the pregnant women followed in our endocrinology department with the diagnosis of gestational diabetes was proceeded. During two stages, 2008-2010 and 2013-2015, analysis of the prevalence of gestational diabetes, maternal characteristics, obstetric outcomes and insulin treatment was taken into account. Results: Between 2008 and 2010, 5.8% (n= 421) of the pregnant women followed by our hospital, were diagnosed with gestational diabetes by the Carpenter and Coustan criteria, of which 198 were included in this study. Between 2013 and 2015, 8.7% (n= 457) were diagnosed with gestational diabetes by the new criteria, of which 294 are included in this study. The pregnant women, diagnosed with the International Association of Diabetes and Pregnancy Study Groups criteria. had a lower body mass index (26.7 kg/m(2) vs 27.6 kg/m(2) ; p= 0.041), more cases of increased weight gain inferior to the recommendations (49.7% vs 29.8%; p< 0.001) and higher needs for insulin treatment (44.2% vs 28.89%; p<0.001). In this same group, the newborn had a lower birth weight (3137 g +/- 465 vs 3274 +/- 475 p= 0.002) and fewer newborns were classified as large for gestational age (4.08% vs 13.5%; p< 0.001). No significant differences were registered in the gestational age (p= 0.883), premature delivery (p= 0.340), mode of delivery (p= 0.506), macrosomia (p= 0.103) or newborns small for gestational age (p= 0.212). Conclusion: The implementation of this new diagnostic criteria led to an increase in the prevalence of gestational diabetes, but there was a higher need for insulin treatment, and improvement of some obstetric outcomes. This study seems to be in favor of the International Association of Diabetes and Pregnancy Study Groups diagnostic criteria.